y very firm, and particularly in some parts.
loaded with black blood.
crowded into a narrow space.

IN THE PERICARDIUM AND ITS CAVITY.

Inflammation and thickening of its substance.
Adhesion to the heart and lungs.
Collection of water in its cavity.

IN THE CAVITY OF THE ABDOMEN.

Collection of water.
Liver very full of fluid blood.
having its tunic flaccid and inflamed.
Mesenteric veins full of blood.

CELLULAR MEMBRANE full of water.

THE BLOOD every where fluid, except in the cavities of the heart.

REMARKS.

The symptoms, which are most observable, in some or all of the
preceding cases, are the following:

The first notice of disorder is commonly from an irregular and
tumultuous movement of the heart, which occurs some time before any
perceptible derangement of the other functions. This irregularity
slowly increases, and arrives at its height before the strength of the
patient is much impaired, at least in the cases which I have noticed;
and as the vigour of the patient lessens, the force of the
palpitations diminishes. These palpitations are often so strong, as to
be perceptible to the eye at a considerable distance. They are seldom
most distinct in the place where the pulsation of the heart is usually
felt. Sometimes they are perceived a little below; often in the
epigastric region; and not unfrequently beneath, and on the right
side, of the sternum.

After the palpitations have lasted some time, a little difficulty of
breathing, accompanied with sighing, is perceived, especially on any
great exertion, ascending an eminence, or taking cold, of which there
is an uncommon susceptibility. This dyspnoea becomes, as it increases,
a most distressing symptom. It is induced by the slightest cause; as
by an irregularity in diet, emotions of the mind, and especially
movement of the body; so that on ascending stairs quickly, the patient
is threatened with immediate suffocation. It occurs at no stated
periods, but is never long absent, nor abates much in violence during
the course of the disease. It is attended with a sensation of
universal distress, which perhaps may arise from the circulation of
unoxygenated blood, or the accumulation of carbon in the system; for
the countenance becomes livid, and the skin, especially that of the
extremities, receives a permanent dark colour. This dyspnoea soon
causes distress in lying in an horizontal postur